Namasivayam-MacDonald Ashwini M, Ayub Aaliyeh, Najeeb Hiba, Shune Samantha E
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
California State University, Northridge.
J Speech Lang Hear Res. 2022 May 11;65(5):1697-1723. doi: 10.1044/2022_JSLHR-21-00502. Epub 2022 Mar 28.
It is important to pinpoint modifiable factors contributing to reduced dysphagia-related quality of life (QoL) in order to improve treatment outcomes and patient health given that a large proportion of stroke survivors experience dysphagia. The purpose of this exploratory study was to identify the independent predictors of dysphagia-related QoL in community-dwelling stroke survivors.
A sample of 31 adult stroke survivors with dysphagia ( = 62 years; 23 males) and their partners ( = 57 years; seven males) participated in the study. Survivors were > 3 months poststroke and living with their partner. Backward regression analysis methods were employed to determine independent predictors of dysphagia-related QoL using scores from the Swallowing-Related Quality of Life questionnaire. Independent variables tested included age, employment status, receiving dysphagia treatment, number of medical conditions, level of diet modification, Stroke Impact Scale (SIS) scores, relationship with partner, partner age, partner employment status, partner burden, and partner depression.
Results indicated that number of survivor medical conditions, degree of diet modification, SIS emotional subscale score, and partner employment status significantly predicted dysphagia-related QoL ( < .001). More specifically, stroke survivors with more medical conditions or a partner who worked outside of the home had worse dysphagia-related QoL, and those with better mental health or a less modified diet had better dysphagia-related QoL.
Factors related to dysphagia-related QoL are multifactorial and include both survivor and spousal variables. The results of this exploratory study highlight the need for clinicians and researchers to consider patient function and needs more wholistically to maximize perceived QoL.
鉴于很大一部分中风幸存者存在吞咽困难，确定导致吞咽困难相关生活质量（QoL）下降的可改变因素对于改善治疗效果和患者健康非常重要。本探索性研究的目的是确定社区中风幸存者吞咽困难相关生活质量的独立预测因素。
31名患有吞咽困难的成年中风幸存者（平均年龄 = 62岁；23名男性）及其伴侣（平均年龄 = 57岁；7名男性）参与了该研究。幸存者中风后超过3个月，与伴侣一起生活。采用向后回归分析方法，使用吞咽相关生活质量问卷的得分来确定吞咽困难相关生活质量的独立预测因素。测试的自变量包括年龄、就业状况、接受吞咽困难治疗情况、疾病数量、饮食调整水平、中风影响量表（SIS）得分、与伴侣的关系、伴侣年龄、伴侣就业状况、伴侣负担和伴侣抑郁程度。
结果表明，幸存者的疾病数量、饮食调整程度、SIS情绪分量表得分和伴侣就业状况显著预测了吞咽困难相关生活质量（P <.001）。更具体地说，患有更多疾病的中风幸存者或伴侣在外工作的幸存者，其吞咽困难相关生活质量较差，而心理健康状况较好或饮食调整较少的幸存者，其吞咽困难相关生活质量较好。
与吞咽困难相关生活质量相关的因素是多方面的，包括幸存者和配偶变量。本探索性研究的结果强调，临床医生和研究人员需要更全面地考虑患者的功能和需求，以最大限度地提高感知生活质量。
